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Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility

INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perfo...

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Autores principales: Cheng, Hui Mei, Zhao, Xiahong, Lim, Wei Shyann, Tan, Beatrice Jia Min, Tey, Hong Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/
https://www.ncbi.nlm.nih.gov/pubmed/34570805
http://dx.doi.org/10.1371/journal.pone.0257565
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author Cheng, Hui Mei
Zhao, Xiahong
Lim, Wei Shyann
Tan, Beatrice Jia Min
Tey, Hong Liang
author_facet Cheng, Hui Mei
Zhao, Xiahong
Lim, Wei Shyann
Tan, Beatrice Jia Min
Tey, Hong Liang
author_sort Cheng, Hui Mei
collection PubMed
description INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. METHODS: In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). RESULTS: Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). CONCLUSIONS: In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result.
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spelling pubmed-84760382021-09-28 Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility Cheng, Hui Mei Zhao, Xiahong Lim, Wei Shyann Tan, Beatrice Jia Min Tey, Hong Liang PLoS One Research Article INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. METHODS: In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). RESULTS: Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). CONCLUSIONS: In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result. Public Library of Science 2021-09-27 /pmc/articles/PMC8476038/ /pubmed/34570805 http://dx.doi.org/10.1371/journal.pone.0257565 Text en © 2021 Cheng et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Cheng, Hui Mei
Zhao, Xiahong
Lim, Wei Shyann
Tan, Beatrice Jia Min
Tey, Hong Liang
Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title_full Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title_fullStr Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title_full_unstemmed Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title_short Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
title_sort factors affecting duration of sars-cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/
https://www.ncbi.nlm.nih.gov/pubmed/34570805
http://dx.doi.org/10.1371/journal.pone.0257565
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